name: title class: title-slide, left, middle background-image: url("data:image/png;base64,#images/daftpunktocat-thomas.gif") background-position: right background-size: contain background-color: #7899d4ff .pull-left[ # A.D.H.D. ## Neuropsychological assessment for diagnostic clarification and treatment planning ### Joey Trampush, Ph.D. ### Della Martin Assistant Professor of Psychiatry ### 2021-12-21 ] --- class: middle, center ### .big-text[Hello.] ??? Our department has grown since 2018 --- class: middle, center .bg-washed-green.b--dark-green.ba.bw2.br3.shadow-5.ph4.mt5[ If you cannot explain something in simple terms, you don't understand it. .tr[ — Richard Feynman ]] .center[] --- class: middle <!-- type: exclaim --> [<svg aria-hidden="true" role="img" viewBox="0 0 496 512" style="height:1em;width:0.97em;vertical-align:-0.125em;margin-left:auto;margin-right:auto;font-size:inherit;fill:currentColor;overflow:visible;position:relative;"><path d="M165.9 397.4c0 2-2.3 3.6-5.2 3.6-3.3.3-5.6-1.3-5.6-3.6 0-2 2.3-3.6 5.2-3.6 3-.3 5.6 1.3 5.6 3.6zm-31.1-4.5c-.7 2 1.3 4.3 4.3 4.9 2.6 1 5.6 0 6.2-2s-1.3-4.3-4.3-5.2c-2.6-.7-5.5.3-6.2 2.3zm44.2-1.7c-2.9.7-4.9 2.6-4.6 4.9.3 2 2.9 3.3 5.9 2.6 2.9-.7 4.9-2.6 4.6-4.6-.3-1.9-3-3.2-5.9-2.9zM244.8 8C106.1 8 0 113.3 0 252c0 110.9 69.8 205.8 169.5 239.2 12.8 2.3 17.3-5.6 17.3-12.1 0-6.2-.3-40.4-.3-61.4 0 0-70 15-84.7-29.8 0 0-11.4-29.1-27.8-36.6 0 0-22.9-15.7 1.6-15.4 0 0 24.9 2 38.6 25.8 21.9 38.6 58.6 27.5 72.9 20.9 2.3-16 8.8-27.1 16-33.7-55.9-6.2-112.3-14.3-112.3-110.5 0-27.5 7.6-41.3 23.6-58.9-2.6-6.5-11.1-33.3 2.6-67.9 20.9-6.5 69 27 69 27 20-5.6 41.5-8.5 62.8-8.5s42.8 2.9 62.8 8.5c0 0 48.1-33.6 69-27 13.7 34.7 5.2 61.4 2.6 67.9 16 17.7 25.8 31.5 25.8 58.9 0 96.5-58.9 104.2-114.8 110.5 9.2 7.9 17 22.9 17 46.4 0 33.7-.3 75.4-.3 83.6 0 6.5 4.6 14.4 17.3 12.1C428.2 457.8 496 362.9 496 252 496 113.3 383.5 8 244.8 8zM97.2 352.9c-1.3 1-1 3.3.7 5.2 1.6 1.6 3.9 2.3 5.2 1 1.3-1 1-3.3-.7-5.2-1.6-1.6-3.9-2.3-5.2-1zm-10.8-8.1c-.7 1.3.3 2.9 2.3 3.9 1.6 1 3.6.7 4.3-.7.7-1.3-.3-2.9-2.3-3.9-2-.6-3.6-.3-4.3.7zm32.4 35.6c-1.6 1.3-1 4.3 1.3 6.2 2.3 2.3 5.2 2.6 6.5 1 1.3-1.3.7-4.3-1.3-6.2-2.2-2.3-5.2-2.6-6.5-1zm-11.4-14.7c-1.6 1-1.6 3.6 0 5.9 1.6 2.3 4.3 3.3 5.6 2.3 1.6-1.3 1.6-3.9 0-6.2-1.4-2.3-4-3.3-5.6-2z"/></svg> @brainworkup](https://github.com/brainworkup) [<svg aria-hidden="true" role="img" viewBox="0 0 512 512" style="height:1em;width:1em;vertical-align:-0.125em;margin-left:auto;margin-right:auto;font-size:inherit;fill:currentColor;overflow:visible;position:relative;"><path d="M459.37 151.716c.325 4.548.325 9.097.325 13.645 0 138.72-105.583 298.558-298.558 298.558-59.452 0-114.68-17.219-161.137-47.106 8.447.974 16.568 1.299 25.34 1.299 49.055 0 94.213-16.568 130.274-44.832-46.132-.975-84.792-31.188-98.112-72.772 6.498.974 12.995 1.624 19.818 1.624 9.421 0 18.843-1.3 27.614-3.573-48.081-9.747-84.143-51.98-84.143-102.985v-1.299c13.969 7.797 30.214 12.67 47.431 13.319-28.264-18.843-46.781-51.005-46.781-87.391 0-19.492 5.197-37.36 14.294-52.954 51.655 63.675 129.3 105.258 216.365 109.807-1.624-7.797-2.599-15.918-2.599-24.04 0-57.828 46.782-104.934 104.934-104.934 30.213 0 57.502 12.67 76.67 33.137 23.715-4.548 46.456-13.32 66.599-25.34-7.798 24.366-24.366 44.833-46.132 57.827 21.117-2.273 41.584-8.122 60.426-16.243-14.292 20.791-32.161 39.308-52.628 54.253z"/></svg> @brainworkup](https://twitter.com/brainworkup) [<svg aria-hidden="true" role="img" viewBox="0 0 512 512" style="height:1em;width:1em;vertical-align:-0.125em;margin-left:auto;margin-right:auto;font-size:inherit;fill:currentColor;overflow:visible;position:relative;"><path d="M326.612 185.391c59.747 59.809 58.927 155.698.36 214.59-.11.12-.24.25-.36.37l-67.2 67.2c-59.27 59.27-155.699 59.262-214.96 0-59.27-59.26-59.27-155.7 0-214.96l37.106-37.106c9.84-9.84 26.786-3.3 27.294 10.606.648 17.722 3.826 35.527 9.69 52.721 1.986 5.822.567 12.262-3.783 16.612l-13.087 13.087c-28.026 28.026-28.905 73.66-1.155 101.96 28.024 28.579 74.086 28.749 102.325.51l67.2-67.19c28.191-28.191 28.073-73.757 0-101.83-3.701-3.694-7.429-6.564-10.341-8.569a16.037 16.037 0 0 1-6.947-12.606c-.396-10.567 3.348-21.456 11.698-29.806l21.054-21.055c5.521-5.521 14.182-6.199 20.584-1.731a152.482 152.482 0 0 1 20.522 17.197zM467.547 44.449c-59.261-59.262-155.69-59.27-214.96 0l-67.2 67.2c-.12.12-.25.25-.36.37-58.566 58.892-59.387 154.781.36 214.59a152.454 152.454 0 0 0 20.521 17.196c6.402 4.468 15.064 3.789 20.584-1.731l21.054-21.055c8.35-8.35 12.094-19.239 11.698-29.806a16.037 16.037 0 0 0-6.947-12.606c-2.912-2.005-6.64-4.875-10.341-8.569-28.073-28.073-28.191-73.639 0-101.83l67.2-67.19c28.239-28.239 74.3-28.069 102.325.51 27.75 28.3 26.872 73.934-1.155 101.96l-13.087 13.087c-4.35 4.35-5.769 10.79-3.783 16.612 5.864 17.194 9.042 34.999 9.69 52.721.509 13.906 17.454 20.446 27.294 10.606l37.106-37.106c59.271-59.259 59.271-155.699.001-214.959z"/></svg> brainworkup.io](https://brainworkup.io) What do I know about .big[ADHD] .right[] .footnote[.red.bold[*] Important footnote] ??? 80HD --- class: middle, left ## Data Science .left[  ] --- class: center middle .big[1.] ## inattention --- class: center middle .big[2.] ## hyperactivity --- class: center middle .big[3.] ## impulsivity --- class: center middle .big[4.] ## working memory --- class: center middle .big[5.] ## stimulus boundness --- class: section, middle <style>body { background-color: red; } </style> <style>body { background-color: blue; } </style> .left[Left hand side content] .center[Middle content] .right[Right hand side content] --- <style>body { background-color: rgba(0, 0, 0, 0.8); } </style> --- class: split-two with-border <style>body { background-color: black; color: white; } </style> .column.bg-main1[ .split-five[ .row.bg-main1[.content[ Row 1, Column 1 content. ]] .row.bg-main2[.content[ Row 2, Column 1 content. ]] .row.bg-main3[.content[ Row 3, Column 1 content. ]] .row.bg-main4[.content[ Row 4, Column 1 content. ]] .row.bg-main5[.content[ Row 5, Column 1 content. ]] ]] .column[.content[ Second column content. ]] --- class: section middle center <style>body { background-color: red; color: white; } </style> #### .big[Clinical ADHD vs Cognitive ADHD] .pull-left[ ### inattention ### hyperactivity ### impulsivity ] .pull-right[ ### working memory ### response variability ### stimulus boundness ] --- class: inverse, middle ### Neurocognitive deficits related to adhd .panelset[ .panel[.panel-name[Working Memory] #### Working Memory - Remembering things short term memory - Verbal information - Nonverbal information - "mind's eye" ] .panel[.panel-name[Processing Speed] #### Processing Speed - Rate of test taking - Rate of speed of information processing - Some other description - Fourth layer ] .panel[.panel-name[Response Variability] #### Response Variability - Reaction time variability - Response consistency - Attentional drift - Impulsive responding ] .panel[.panel-name[Inhibitory Control] #### Inhibitory Control - Go/No-Go performance - Core DSM symptom (impulsivity) - Something else ... - Impulsive responding ] ] --- name: bell class: left, middle, fullscale background-image: url(data:image/png;base64,#https://gifs.joelglovier.com/crying/laughing-crying.gif) background-position: 50% 50% background-size: 100% #### Emotional Control .pull-left[ > **Emotion** 🔥 > > **(Dys)Regulation** > > in **ADHD** > > Not part of DSM/ICD diagnostic criteria > > .big[BUT] ... > ] ??? This is recognized on most rating scales e.g., brown --- class: middle, center .frame[ ### Read these words as fast as you can ] --- class: middle, center .frame[ ### RED ] .frame[ ### GREEN ] .frame[ ### BLUE ] .frame[ ### YELLOW ] ??? This is how we test it --- class: middle, center .frame[ ### .red[RED] ] .frame[ ### .green[GREEN] ] .frame[ ### .blue[BLUE] ] .frame[ ### .yellow[YELLOW] ] ??? Also how --- class: middle, center .frame[ ### .purple[RED] ### .orange[GREEN] ### .pink[BLUE] ### .green[YELLOW] ] ??? This is how we test it --- name: agenda class: middle, center ## Agenda The .blue[name] of this slide is {{ name }}. --- <style> table { table-layout: auto; width: 100%; color: black; font-size: 12px; font-family: 'Roboto Condensed', 'Metrophobic', 'Aldrich'; break-inside: avoid; } </style> <style> caption { color: black; font-weight: bold; font-size: 14px; font-family: 'Roboto Condensed', 'Metrophobic', 'Aldrich'; } </style> Schools cannot diagnose ADHD, other health/med --- class: middle center inverse animated slideInRight fadeOutLeft ### Distribution of Scores: _Population-level Interpretation_ <div class="figure"> <img src="data:image/png;base64,#images/plot_narrow.png" alt="Statistical classification of neuropsychological test scores in the general population." width="50%" /> <p class="caption">Statistical classification of neuropsychological test scores in the general population.</p> </div> --- class: middle center inverse animated slideInLeft fadeOutRight ### Distribution of Scores: _Clinical Interpretation_ <div class="figure"> <img src="data:image/png;base64,#images/plot_broad.png" alt="General clinical interpretation of performance for individual test scores and broader neuropsychological domains." width="50%" /> <p class="caption">General clinical interpretation of performance for individual test scores and broader neuropsychological domains.</p> </div> --- class: inverse middle center #### Highcharte`R` Drilldown ###### Z-scores (Mean = 0, SD = 1) <div class="figure"> <div id="htmlwidget-6e6db1bd44c337ec2467" style="width:100%;height:500px;" class="highchart html-widget"></div> <script type="application/json" 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